Back Pain Surgery
Operative treatments continued...
Regardless of how spinal fusion is performed, the fused area of
the spine becomes immobilized.
For vertebral osteoporotic
When back pain is
caused by a compression fracture of a vertebra due to osteoporosis or trauma,
doctors may make a small incision in the skin over the affected area and inject
a cement-like mixture called polymethyacrylate into the fractured vertebra to
relieve pain and stabilize the spine. The procedure is generally performed on
an outpatient basis under a mild anesthetic.
3 Used only if standard
care, rest, corsets/braces, analgesics fail.
vertebroplasty, kyphoplasty is used to relieve pain and stabilize the spine
following fractures due to osteoporosis. Kyphoplasty is a two-step process. In
the first step, the doctor inserts a balloon device to help restore the height
and shape of the spine. In the second step, he or she injects polymethyacrylate
to repair the fractured vertebra. The procedure is done under anesthesia, and
in some cases it is performed on an outpatient basis.
For Discogenic Low Back Pain (Degenerative Disc
Intradiscal electrothermal therapy
One of the newest and least invasive therapies for low
back pain involves inserting a heating wire through a small incision in the
back and into a disc. An electrical current is then passed through the wire to
strengthen the collagen fibers that hold the disc together. The procedure is
done on an outpatient basis, often under local anesthesia. The usefulness
of IDT is debatable.
When the degenerated
disc is painful, the surgeon may recommend removing it and fusing the disc to
help with the pain. This fusion can be done through the abdomen, a procedure
known as anterior lumbar interbody fusion, or through the back, called
posterior fusion. Theoretically, fusion surgery should eliminate the source
of pain; the procedure is successful in about 60 to 70 percent of cases.
Fusion for low back pain or any spinal surgeries should only be done as a last
resort, and the patient should be fully informed of risks.
When a disc is
herniated, one alternative to a discectomy - in which the disc is simply
removed - is removing it and replacing it with a synthetic disc. Replacing the
damaged one with an artificial one restores disc height and movement between
the vertebrae. Artificial discs come in several designs.
Although doctors in Europe had performed disc replacement
for more than a decade, the procedure had been experimental in the United
States until the Food and Drug Administration approved the Charite artificial
disc (http://www.fda.gov/cdrh/mda/docs/p040006.htm) for use.